Abstract

Breathing and crying by newly-born preterm infants in an era of delayed cord clamping

Presented at the Neonatal Society 2018 Summer Meeting.

Murphy MC1,2,3, McCarthy LK1, O’Donnell CPF1,2,3

1 National Maternity Hospital, Dublin, Ireland2 National Children’s Research Centre, OLCHC, Dublin, Ireland3 School of Medicine, University College Dublin, Ireland

Background: The majority of newly-born preterm infants breathe and cry after immediate cord clamping (1). Guidelines now recommend delayed cord clamping (DCC) for at least 30 seconds for infants who do not require immediate resuscitation. We wished to study the breathing and crying by extremely preterm infants after cord clamping in an era of DCC.

Methods: We reviewed video recordings of infants born < 28 weeks’ gestational age (GA) or with a birth weight (BW) < 1000g at our tertiary maternity hospital with ethical approval and parental consent. We recorded the time after birth at which the infant arrived to the resuscitaire, and whether the infant had an audible cry and/or visible breathing before respiratory support was given.

Results: We reviewed videos of 35 infants [mean (SD) GA 27 (1.5) weeks, BW 890 (200) g]. Infants arrived to the resuscitaire at a median (IQR) 80 (64, 85) seconds of life. Six (17%) infants arrived before or at 30s [median (IQR) 28 (18, 30) s]; 4 had an audible cry and breathed, while the other 2 breathed without crying. Twenty-nine (83%) infants arrived after 30s [median (IQR) 81 (79, 87) s]; 20 had an audible cry and breathed while a further 6 breathed without crying. Respiratory support was given by mask to all 35 infants. Five (14%) infants were intubated in the delivery room, 2/6 infants who arrived before 30s and 3/29 infants who arrived after 30s.

Conclusion: The majority of extremely preterm infants breathed and cried after DCC.